Breakthrough bleeding with an IUD after one year

An IUD can affect bleeding, but a change after a previously settled pattern may have another explanation. Do not remove or reposition the device yourself.

The pattern may relate to the type of IUD, a device that has shifted or is being expelled, pregnancy, infection, a cervical change, or a condition in the uterus. Endometrial polyps can present with bleeding between periods, but the symptom alone cannot identify the cause.

Pelvic pain, pain during sex, unusual discharge, fever, missing threads, or threads that feel different are details to report. Chlamydia can present with bleeding between periods or after sex and may cause few other symptoms.

Take a pregnancy test if pregnancy is possible, and use backup contraception if you cannot feel the threads or the device may have moved. Arrange an appointment for a thread check and assessment rather than trying to reach farther into the vagina or pull on anything.

Bring the IUD insertion date and device type if known. A clinician may consider an examination, infection testing, or ultrasound based on the bleeding pattern, pain, pregnancy test, and thread findings.

Get urgent care for severe or one-sided pelvic pain, fainting, shoulder-tip pain, very heavy bleeding, fever with pelvic pain, or a positive pregnancy test with pain or bleeding. Pregnancy with an IUD needs prompt assessment to determine its location and guide safe care.

Ask whether the threads and device position need checking, whether infection or pregnancy testing is appropriate, and whether you need temporary backup contraception. Clarify what bleeding pattern is expected for your IUD type and when follow-up should occur.